Bert J. Rico
Founder And Chief Executive Officer
Glass box insights, not black box dashboards.
Dover, DE
Background
Bert J. Rico is Founder and Chief Executive Officer of ClearStars, the Medicare Advantage Stars analytics and healthcare compliance company he built on one conviction: clear insights drive 5 star outcomes. He leads technology, engineering, and product, and partners with COO and Co-Founder Pedro Cerrate on marketing and sales. Bert brings nearly two decades in healthcare and Medicare Advantage quality analytics to turning CMS Star Ratings from a maze into a playbook.
Across payer operations, clinical analytics, and health plan leadership, Bert has contributed to three 5 Star CMS contracts, including leading a regional health plan to its first ever 5 Star rating. He carries deep command of Star Ratings methodology, cut points, bubble measures, and contract level performance, with fluency across quality measurement, member and provider survey instruments, electronic clinical data reporting and digital quality, health equity, and value-based care.
His impact shows up in the numbers. Selected for an NCQA field testing pilot, Bert built the measure logic, data flows, and validations for three measures using electronic clinical data, two of which are now in the measure set. He cut a health plan's audit issue log by 75 percent and removed more than $730,000 in annual analytics expense through consolidation and automation. Before founding ClearStars, he built the ingestion, validation, and measure logic behind a quality measure engine.
Bert is hands on across payer data pipelines in Snowflake, dbt, and SQL Server, and he builds and runs AI assisted analytics in production. He fine-tunes self-hosted language models on CMS technical notes and Star Ratings source material while keeping all financial and measure math deterministic, so sensitive calculations never run through a generative path.
He pursued doctoral coursework in Health Informatics at UT Health Science Center at Houston and earned a B.S. in Computer Software Engineering, magna cum laude, from Barry University. At ClearStars, Bert leads engagements end to end and delivers the work personally, building the Stars intelligence and the deterministic analytics that serve Medicare Advantage plans and their members.
Areas Of Focus
Where nearly two decades of Medicare Advantage Stars analytics have gone, in the terms a quality or analytics team already uses.
- Star Ratings methodology, cut points, bubble measures, and contract level performance.
- Quality measurement, including member and provider survey instruments.
- Electronic clinical data reporting and digital quality.
- Health equity and value-based care.
- Payer data pipelines in Snowflake, dbt, and SQL Server.
- Deterministic financial and measure math, kept off any generative path.
Ask Me About
Good first questions for a meeting. Each is work Bert leads or has written about, and the link goes to the detail, so you can read it before you book.
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See Managed Data
Running Your Stars Data
How our team would run your pipelines, warehouse and Star Ratings reporting, with Meteor included, in engagements Bert leads.
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Read the analysis
The CY2027 Final Rule
CMS removed 11 Star Ratings measures and kept the historical reward factor instead of the Health Equity Index. What that changes.
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Read the analysis
Cut Point And Weighting Math
Patient experience measures dropped to weight 2 for the 2026 Star Ratings while clinical outcomes stay at weight 3. How to read it, and where to spend.
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Read the analysis
Quality Bonus Dollars In 2027
With the final 2027 rate set and medical costs running high, why every fraction of a Star reaches the balance sheet.
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Read the analysis
The New Depression Screening Measure
A Part C depression screening and follow-up measure, starting with the 2027 measurement year and the 2029 Star Ratings. What to do now.
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Read the analysis
Data Ready For FHIR And CQL
NCQA is retiring the hybrid method by measurement year 2029 and going fully digital by 2030, with measure logic in FHIR and CQL. Is your data ready?
Questions For Bert
He is Founder and CEO. Bert leads technology, engineering and product, partners with COO and Co-Founder Pedro Cerrate on marketing and sales, and leads client engagements end to end, delivering the work personally.
Nearly two decades in healthcare and Medicare Advantage quality analytics, across payer operations, clinical analytics and health plan leadership. He has contributed to three 5 Star CMS contracts, including leading a regional health plan to its first ever 5 Star rating, and built the logic for three measures in an NCQA field testing pilot, two of which are now in the measure set.
Yes. Managed Data and Analytics engagements are staffed by our team and led by Bert, who leads engagements end to end and delivers the work personally. Book a meeting to start the conversation.
Use Book A Meeting at the top of this page. It opens his calendar, where you pick a time and get a calendar invitation with the meeting link. If nothing fits, write to bert.rico@clearstars.ai with a couple of windows.
In Insights. Bert has written on the CY2027 final rule, the new cut point and weighting math, quality bonus dollars in 2027, the new depression screening measure, and readiness for digital quality measures in FHIR and CQL.
Only around the math, never inside it. He fine-tunes self-hosted language models on CMS technical notes and Star Ratings source material, and all financial and measure math stays deterministic, so sensitive calculations never run through a generative path.
Find Me Elsewhere
Book Time With Bert
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